Nursing Elites

1. A client has a new prescription for Alendronate. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Remain upright for 30 minutes after taking the medication.
• C. Take this medication with food.
• D. Increase your intake of calcium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to remain upright for 30 minutes after taking Alendronate. Alendronate can cause esophageal irritation and even ulceration if it remains in contact with the esophagus. By staying upright, the medication is more likely to pass through the esophagus and into the stomach, reducing the risk of irritation and complications. Choice A is incorrect because Alendronate should be taken in the morning, not at bedtime, and the client should remain upright after taking it. Choice C is incorrect because Alendronate should be taken on an empty stomach, usually in the morning, to enhance absorption. Choice D is incorrect because while calcium intake is important, it is not directly related to the administration of Alendronate.

2. A client is prescribed Clopidogrel. Which of the following laboratory values should be monitored to assess for potential adverse effects?

• A. White blood cell count
• B. Platelet count
• C. Hemoglobin
• D. Blood glucose

Correct answer: B

Rationale: Clopidogrel is an antiplatelet medication, so monitoring the client's platelet count is crucial to assess for potential bleeding complications. Changes in platelet count can indicate an increased risk of bleeding, a known adverse effect of Clopidogrel. Monitoring white blood cell count, hemoglobin, or blood glucose is not directly related to the potential adverse effects of Clopidogrel and would not provide relevant information regarding the medication's impact on platelet function.

3. A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?

• A. Obtain a blood specimen immediately prior to administering the next dose of medication.
• B. Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen.
• C. Ask the client to provide a urine specimen after the next dose of medication.
• D. Administer the medication and obtain a blood specimen 30 minutes later.

Correct answer: A

Rationale: To verify the trough levels of a medication accurately, the nurse should obtain a blood specimen immediately before administering the next dose of the medication. The trough level represents the lowest concentration of the medication in the bloodstream, typically right before the next dose is due. This timing ensures an accurate assessment of the drug's concentration in the body at its lowest point, aiding in determining the drug's effectiveness and potential toxicity levels. Choice B is incorrect because waiting for 24 hours would not provide the trough level. Choice C is incorrect as urine specimens are not used to measure trough levels. Choice D is incorrect as obtaining a blood specimen 30 minutes after administering the medication would not reflect the trough level.

4. A client in an acute care facility is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

• A. Intestinal ileus
• B. Neutropenia
• C. Delirium
• D. Hyperthermia

Correct answer: C

Rationale: The correct answer is C: Delirium. When IV Nitroprusside is infused at high dosages, it can lead to thiocyanate toxicity, causing mental status changes such as delirium. It is crucial to monitor the thiocyanate levels to ensure they remain below 10 mg/dL during therapy to prevent adverse effects. Choices A, B, and D are incorrect because IV Nitroprusside is not commonly associated with intestinal ileus, neutropenia, or hyperthermia. Monitoring for delirium is crucial due to the risk of thiocyanate toxicity.

5. A healthcare professional is preparing to administer furosemide 80 mg PO daily. The available furosemide oral solution is 10 mg/1 mL. How many mL should the healthcare professional administer?

• A. 8 mL
• B. 10 mL
• C. 6 mL
• D. 12 mL

Correct answer: A

Rationale: To determine the volume to administer, divide the desired dose by the available concentration. In this case, 80 mg divided by 10 mg/mL equals 8 mL. Therefore, the healthcare professional should administer 8 mL of furosemide oral solution. Choice B, 10 mL, is incorrect as it does not reflect the accurate calculation. Choices C and D, 6 mL and 12 mL respectively, are also incorrect as they do not match the correct calculation based on the provided concentration and dose.

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